Testing and implementing promising new diagnostics measures and ideas in Iowa hospitals to significantly reduce falls

The purpose of this project is to develop a set of comprehensive changes in the delivery of care that will help hospital staff to reduce harm from patient falls on medical-surgical units. Patient falls are a leading cause of harm among older hospitalized patients. Falls affect patient mortality and morbidity, and negatively impact the nursing work environment, resulting in reduced nursing satisfaction and retention. Although research has been conducted on interventions to reduce falls, little work has been done to help nurses know the combination of possible interventions that have the greatest likelihood of reducing falls and reducing harm from falls. The objective of this project is to identify a change package of interventions that collectively demonstrate significant reduction in harm from falls that occur in hospital medical-surgical units. Seven healthcare organizations, selected based on strong leadership, commitment to a culture of innovation and high-quality care, and significant progress in reducing harm from falls, will pilot test and measure the impact of combinations of interventions to reduce harm from falls. Foundation funds will be used for nursing staff time to test, measure and report the impact of individual and multiple interventions that would be part of a change package of interventions. The Institute for Healthcare Improvement (IHI) has been chosen to lead this work and will engage each organization's leaders and frontline care teams in a collaborative learning process, with substantial technical assistance resources. The outcomes of the work will guide IHI and RWJF in developing tools and resources aimed at reducing harm from falls. A subsequent white paper will be prepared that describes the extent of patient harm from falls, relevant clinical research, key changes implemented to prevent harm from falls, measures used to track falls, and results achieved by these participating hospitals. Both IHI and RWJF have committed to disseminating this document widely to both the hospital and long term care communities at large.